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Individual
JAY WALTER HEINECKE
Active
Individual
JAY WALTER HEINECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD00020145
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027127
—
WA
01
—
5218
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/13/2006
Last updated
07/08/2007
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